Neuromuscular impairments are associated with impaired head and trunk stability during gait in Parkinson fallers

Cole, Michael H., Naughton, Geraldine A. and Silburn, Peter A. (2017) Neuromuscular impairments are associated with impaired head and trunk stability during gait in Parkinson fallers. Neurorehabilitation and Neural Repair, 31 1: 34-47. doi:10.1177/1545968316656057


Author Cole, Michael H.
Naughton, Geraldine A.
Silburn, Peter A.
Title Neuromuscular impairments are associated with impaired head and trunk stability during gait in Parkinson fallers
Journal name Neurorehabilitation and Neural Repair   Check publisher's open access policy
ISSN 1552-6844
1545-9683
Publication date 2017-01-01
Year available 2016
Sub-type Article (original research)
DOI 10.1177/1545968316656057
Open Access Status Not yet assessed
Volume 31
Issue 1
Start page 34
End page 47
Total pages 14
Place of publication Thousand Oaks, CA, United States
Publisher Sage Publications
Language eng
Formatted abstract
Background: The trunk plays a critical role in attenuating movement-related forces that threaten to challenge the body's postural control system. For people with Parkinson's disease (PD), disease progression often leads to dopamine-resistant axial symptoms, which impair trunk control and increase falls risk.

Objective: This prospective study aimed to evaluate the relationship between impaired trunk muscle function, segmental coordination, and future falls in people with PD. Methods. Seventy-nine PD patients and 82 age-matched controls completed clinical assessments and questionnaires to establish their medical history, symptom severity, balance confidence, and falls history. Gait characteristics and trunk muscle activity were assessed using 3-dimensional motion analysis and surface electromyography. The incidence, cause, and consequence of any falls experienced over the next 12 months were recorded and indicated that 48 PD and 29 control participants fell at least once during this time.

Results: PD fallers had greater peak and baseline lumbar multifidus (LMF) and thoracic erector spinae (TES) activations than control fallers and nonfallers. Analysis of covariance indicated that the higher LMF activity was attributable to the stooped posture adopted by PD fallers, but TES activity was independent of medication use, symptom severity, and trunk orientation. Furthermore, greater LMF and TES baseline activity contributed to increasing lateral head, trunk, and pelvis movements in PD fallers but not nonfallers or controls.

Conclusions: The results provide evidence of neuromuscular deficits for PD fallers that are independent of medications, symptom severity, and posture and contribute to impaired head, trunk, and pelvis control associated with falls in this population.
Keyword Accidental falls
Electromyography
Parkinson disease
Quality of life
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
School of Medicine Publications
 
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